Prostheses Billing Services

Prostheses billing services USA-Prosthetic Limbs

Prostheses Care is Complex For Several Reasons

Prostheses Billing Services USA go beyond standard medical billing, requiring specialized knowledge to handle claims for prostheses, orthotics, and durable medical equipment (DME). These items must be properly coded and documented before insurers or government payers will consider reimbursement. Each payer has its own set of rules and coverage conditions, making it challenging for medical office staff to keep up. Expert billing services ensure compliance, reduce denials, and streamline the reimbursement process for these critical devices.

Outsourcing Medical Billing And Coding

Partnering with a professional revenue cycle management (RCM) company like Med Billing RES for medical billing and consulting services has been a hassle-free way to boost our clients’ income. Our certified billers are skilled in handling prostheses, and all our staff are thoroughly trained in HIPAA compliance, ensuring patient data remains secure.

The coding for fitting and adjusting prostheses already includes the office visit, so billers need to be mindful not to add the code for a visit separately in the claim.

There’s some overlap in the codes for providing and adjusting prostheses and the time a skilled clinician spends training the user. Those billing for prosthetics need to accurately identify and code each instance, using modifiers to indicate reduced services and avoid duplicate payments. Not doing so can lead to over-coding and, ultimately, fraud charges against the physician.

Some prosthetic devices haven’t gone through product review, so they lack specific codes. Medical coders and billers need to figure out the right codes in these situations, which can be a time-consuming process. This often results in labor costs outweighing the value of the claim.

Opening Hours

Mon – Fri

08.00 -18.00

Sat – Sun

09.00 -15.00

Prostheses Care is Complex For Several Reasons

Medical billing isn’t just about services. Prostheses, orthotics, and durable medical equipment (DME) also need to be coded and included in a claim before insurers or government payers will cover the costs. Each payer has its own rules and guidelines for prostheses billing, determining what’s covered and under what conditions, making it tough for medical office staff to stay on top of everything.

Someone Examining prosthetic leg
Prostheses billing services USA-Depiction of tech

Outsourcing Medical Billing And Coding

Partnering with a professional revenue cycle management (RCM) company like Med Billing RES for medical billing and consulting services has been a hassle-free way to boost our clients' income. Our certified billers are skilled in handling prostheses, and all our staff are thoroughly trained in HIPAA compliance, ensuring patient data remains secure.

Fitting And Adjustment Appointments

The coding for fitting and adjusting prostheses already includes the office visit, so billers need to be mindful not to add the code for a visit separately in the claim.

Doctor consulting with patients
Prostheses billing services USA-Code

Overlapping Codes

There’s some overlap in the codes for providing and adjusting prostheses and the time a skilled clinician spends training the user. Those billing for prosthetics need to accurately identify and code each instance, using modifiers to indicate reduced services and avoid duplicate payments. Not doing so can lead to over-coding and, ultimately, fraud charges against the physician.

Uncoded Products

Some prosthetic devices haven’t gone through product review, so they lack specific codes. Medical coders and billers need to figure out the right codes in these situations, which can be a time-consuming process. This often results in labor costs outweighing the value of the claim.

Prosthetic Limb

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